Clinical Hemorheology and Microcirculation - Volume 10, issue 3
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Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research.
The endeavour of the Editors-in-Chief and publishers of
Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of
Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process.
Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.
The following professionals and institutions will benefit most from subscribing to
Clinical Hemorheology and Microcirculation: medical practitioners in all fields including hematology, cardiology, geriatrics, angiology, surgery, obstetrics and gynecology, ophthalmology, otology, and neurology. Pharmacologists, clinical laboratories, blood transfusion centres, manufacturing firms producing diagnostic instruments, and the pharmaceutical industry will also benefit.
Important new topics will increasingly claim more pages of
Clinical Hemorheology and Microcirculation: the role of hemorheological and microcirculatory disturbances for epidemiology and prognosis, in particular regarding cardiovascular disorders, as well as its significance in the field of geriatrics. Authors and readers are invited to contact the editors for specific information or to make suggestions.
Abstract: We have devised a microcomputer-based filtration technique for erythrocyte deform ability studies. The system receives the output from a pressure transducer and can continuously vary the flow rate or the filtration pressure via a programmable pump. Measurement may be performed either at constant flow rate or at constant pressure under feedback control. The initial steady state relative filtration pressure (iRFP) at constant flow rate or initial relative flow rate at constant pressure (iRFR) may be used to assess erythrocyte deformability. Blood was anticoagulated with, either heparin or EDT A. Leucocytes and platelets were removed by pre-filtration through Imugard cotton wool.…For deformability studies, erythrocyte suspensions at 5% haematocrit were filtered through Hemafil PC membranes with 4.7 micron pores. The mean iRFP value from 33 experiments was 1.335 ± 0.049. When 5 µM dipyridamole was present in the cell suspension, the iRFP was reduced to 1.224 ± 0.057 (p<0.0001). Similar results were obtained from filtrations at constant pressure. This finding suggests that dipyridamole may be beneficial when impaired erythrocyte deformability contributes to microcirculatory pathology. Leucocyte and platelet removal was more efficient with heparin than with EDT A and the filtration results were also more improved. Heparin which does not deplete Ca++ , may be the anticoagulant of choice for erythrocyte deformability studies.
Abstract: A comparison of the relative efficacy of three commercial filtrometers (Hemorheometre, St. George’s Filtrometer and Cell Transit Analyser) for the measurement of erythrocyte deformability has been made in vitro using six test models (osmotic stress, thermal injury, cell density, sickle cells, diamide-treated cells, and valinomycin-dehydrated cells). The Cell Transit Analyser provided more information on the flow times of individual erythrocytes but showed lower sensitivity, compared with the initial-flow-rate Hemorheometre and St. George’s filtrometers, for the detection of whole populations and sub-populations of poorly deformable erythrocytes. The higher sensitivity of the two initial-flow-rate filtrometers is derived from their ability to…detect the cumulative effect of slow-flowing and pore-clogging cells. For clinical studies, it is therefore important to select a filtrometer that is sensitive to the rheological parameters of the cell populations to be studied.
Abstract: A comparative study of the effects of plasma substitutes on apparent blood viscosity was made at low and high shear rates. Red cells from normal donors were resuspended in their own plasma diluted with plasma substitutes or saline. The haematocrit was 40%. There were significant differences between the viscosities of the diluents studied. Hydroxyethyl starch and dextran substitutes had viscosities ranging from 1.7 to 2.5 times that of plasma whilst gelatins showed viscosities similar to plasma. At clinically relevant plasma dilutions there were very small effects of plasma substitutes on apparent blood viscosity at high shear rates. At low shear…rates, however, there were larger changes in apparent blood viscosity. The two solutions which caused least change in apparent blood viscosity compared to no plasma dilution were 3.5% polygeline, a small molecular weight gelatin, and 6% diafiltered hydroxyethyl starch with a degree of substitution of 5 and comparatively narrow range of moderately sized molecules. The latter solution had the highest number average molecular weight of all the solutions studied and may prove advantageous in low flow states associated with capillary leak.
Keywords: Plasma substitutes, viscosity, Dextrans, hydroxyethyl starch, gelatins, albumin
Abstract: In a randomized double-blinded placebo-controlled study the effects of 100 mg fenofibrate TD were investigated in 22 patients suffering from hyperlipoproteinemia type IIa and IIb with respect to whole-blood viscosity, erythrocyte aggregation, plasma viscosity, fibrinogen, and lipoprotein concentrations. Fenofibrate led to significant decreases of VLDL and LDL lipoprotein concentrations. Fibrinogen and alpha 2 macroglobulin remained constant. Whereas whole-blood and plasma viscosity was reduced significantly, erythrocyte aggregation remained unchanged under fenofibrate. We conclude that the reduction of blood viscosity is due to the change in lipoprotein concentrations, mainly LDL fraction, even if we found no quantitative correlation between the parameters.
Abstract: A Study of cerebro-vascular diseases was carried out by testing hematocrit (X1), whole blood relative viscosity against saline (X2), whole blood reduced viscosity (X3) which was defined as (X2–1)/X1, plasma viscosity against saline (X4), erythrocyte electrophoretic time in their own plasma (X5), erythrocyte sedimentation rate (ESR, X6), ESR equation coefficient (X7), fibrinogen(X8), platelet electrophoretic time in their own plasma(X9), ADP inducing platelets and erythrocytes to produce slow percentages in electrophoretic behaviors (X10 and X11) for ischemic strokes (IS), hemorrhagic strokes (HS) and other relative disorders. The pathogenesis of IS was partially connected to the abnormality in hemorheology according to the…increases of X1–X11 in the acute phase, and decreases of X1–X5 and X8 during the following periods since onset till 1–2 weeks, 3–6 months and 1–2 Years. Hemodilution was suggested in acute phase for IS patients and a injective preparation extracted from a Chinese traditional herb named DANGSHENG obtained better results than the low molecular weight dextran. A compound decoct ion of Chinese traditional herbs named PUYANHUAWUTANG, showed better results than routine measures to treat IS sequela. Some aspects of hemorheology differences and identity for IS and HS groups were discussed. The electrophoretic behaviors of erythrocytes and platelets and their ADP inducing slow-down were also discussed.
Abstract: An international, multi-centre trial was carried out to test the haemorheological effects of ketanserin, a serotonin antagonist, after treatment of intermittent claudicants for 1 year. Haematological indices, whole blood viscosity, plasma viscosity and red cell and white cell filterability were measured using standardized techniques. Even so, inter-laboratory variability, and intra-laboratory changes in control values in some centres over the 1 year period proved to be major obstacles. The pooled data showed no evidence of haemorheological changes, although data from the single largest centre indicated slightly lowered haematocrit and blood and plasma viscosity. Any rheological effects of serotonin antagonists in intermittent…claudicants are probably small and unlikely to be the main source of any clinical efficacy. In general, it would appear that standardization and monitoring of laboratory techniques must be strictly carried out if there is to be any hope of successfully carrying out multi-centre haemorheological trials.
Abstract: Ischaemic heart disease is a condition which can range from a simple coronary insufficiency of oxygen to a more complicated form of myocardial infarction and heart failure. In the current paper an attempt has been made to understand the hemorheological pattern in the most simplest form of ischaemia and also in case of ischaemics with old hypertension. Except for plasma viscosity and red cell aggregation no other rheological parameter was significant. An attempt has been made to understand the confounding effect of hematocrit and plasma viscosity on whole blood viscosity. Correlation analysis between the enzymes which are known to be…diagnostic in diseases like myocardial infarction have yielded non significant results.
Abstract: Despite the extensive research demonstrating the benefits of lipid lowering therapy in occlusive arterial disease, there is a paucity of data on the rheological effects of such treatment. We have investigated the rheological effects of gemfibrozil in 50 patients with angiographically documented but stable peripheral occlusive arterial disease. Serum lipids, plasma fibrinogen, whole blood viscosity, plasma viscosity, red cell aggregability and red cell deformability were measured on two baseline samples, separated by 2 weeks of treatment with placebo, and compared with the results obtained after 12 weeks of gemfibrozil (Lopid) 600mg b.d. Treatment with gemfibrozil resulted in a significant…reduction in mean serum cholesterol (6.42 mmol/l to 5.62 mmol/l; p<0.01) and triglyceride values (2.25 mmol/l to 1.61 mmol/l; p=0.02) coupled with a decrease in haematocrit (45.4% to 44.6%; p<0.01) but an overall increase in plasma fibrinogen (3.42 to 3.88 g/l; p<0.01). The net effects of gemfibrozil were to increase mean plasma viscosity, reduce red cell deformability and aggregation and leave native whole blood viscosity unchanged. The changes in fibrinogen and plasma viscosity are of particular concern and have not been previously documented.